Human diphyllobothriasis is a parasitic disease caused by ingestion of larvae (plerocercoids) in raw or undercooked fish and commonly found in temperate areas. Rare cases were reported in tropical or subtropical areas especially in children. The first documented case of pediatric diphyllobothriasis in Taiwan had been reported 11 years ago. Here, we report another 8-year-old girl case who presented with a live noodle-like worm hanging down from her anus, with no other detectable symptoms. We pulled the worm out and found the strobila being 260 cm in length. Examination of gravid proglottids showed that they were wider than their lengths, containing an ovoid cirrus sac in the anterior side and the rosette-shaped uterus. Eggs extracted from the uterus were ovoid and operculated. Diphyllobothrium latum was confirmed by molecular analysis of the mitochondrial DNA cytochrome c oxidase subunit 1 (cox1) gene. The girl was treated with a single oral dose of praziquantel, and no eggs or proglottids were observed from her stool in the subsequent 3 months. The reemergence of human diphyllobothriasis in non-endemic countries is probably due to prevalent habit of eating imported raw fish from endemic areas. This pediatric case raised our concern that human diphyllobothriasis is likely underestimated because of unremarkable symptoms.
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机译：人双叶鞭毛虫病是一种寄生虫病，是由未煮熟或未煮熟的鱼食入幼虫（猪尾藻）引起的，通常在温带地区发现。在热带或亚热带地区，特别是在儿童中，报告了罕见的病例。台湾11年前已报告了第一例小儿双叶鞭毛虫病。在这里，我们报告了另一例8岁的女病人，她的肛门下垂着一条活的面条状蠕虫，没有其他可检测到的症状。我们将蠕虫拔出，发现长260厘米的strobila。妊娠前突检查发现它们长于其长度，在前侧和卵形子宫中含有卵圆形卷囊。从子宫中取出的卵是卵形的并且被操作。线粒体DNA细胞色素 c 氧化酶亚基1（ x1 ）基因的分子分析证实了 Diphyllobothrium latum 。该女孩接受口服吡喹酮单次治疗，在随后的三个月中未从其粪便中观察到卵或前列腺炎。在非流行国家，人类双毛鞭毛虫病的重新出现可能是由于人们普遍习惯于从流行地区进食进口生鱼。该儿科病例引起了我们的关注，由于症状不明显，人双毛鞭毛虫病可能被低估了。
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